The Press
May 3 2008

Doctor suspected sexual abuse
by Dean Calcott

A doctor suspected sexual abuse after examining a desperately sick Charlene Makaza, the trial of her adoptive father was told yesterday.

In the High Court in Christchurch, general practitioner Dr Graeme Carpenter was giving evidence in the case of George Evans Gwaze, 56, who denies a charge of murder and two counts of sexual violation of his 10-year-old adopted daughter, Charlene. She died in Christchurch Hospital on January 7 last year.

The Crown says she died after a violent sexual assault, and the defence that she succumbed from natural causes, probably an overwhelming infection.

Carpenter told the court that on January 5 last year he was nearing the end of a night shift in the 24-hour surgery in Bealey Avenue when Charlene was brought in by family members about 6.45am.

She was lying still and unconscious, breathing rapidly with an occasional deep breath, and her eyes were closed.

Her pulse was 180, temperature over 40deg _ 37deg being normal _ and nurses said her blood pressure was unreadable. On a scale which measured consciousness she scored a three, the lowest possible.

"She was desperately unwell. She needed hospital care right that second, and preferably earlier," Carpenter said.

Nurses had already called an ambulance and his only concern was maintaining the child until she was taken to Christchurch Hospital, Carpenter said.

The family said she was found like that earlier in the morning and had seemed well the night before.

Her lungs were fill of crepitations, the sound made when air is bubbling through fluid.

Carpenter suspected Charlene suffered from meningococcal septicaemia, a rare but deadly illness. She was given a saline drip to keep up fluid levels, and an anal suppository of painkiller by a nurse.

After it was administered, the nurse said she had found blood.

At that point another possible diagnosis presented itself, one he did not particularly want to consider, that of some sort of trauma or injury to the anus or rectum.

Carpenter said he had not expected that and had not encountered it before. "It was altogether upsetting and unsettling."

There had to be a possibility some sort of abuse had occurred and any examination had to be undertaken by someone skilled in sexual-abuse cases, Carpenter said.

He telephoned Christchurch Hospital's emergency department, and explained the situation. He did not mention any concerns about abuse but told staff a nurse had found blood when she inserted a suppository, and that the rectum should be examined.

He was then advised to administer antibiotics through the intravenous line, which he did.

The ambulance arrived and he tried to impress on officers the need for speed to get to the hospital.

He then noticed a bluish tinge around the side of one of Charlene's feet, which indicated her body was shutting down, something which happened in extreme illness.

It showed she was even more ill than he realised, and it was a sign death was imminent, Carpenter said.

The case resumes on Monday.